[New peritoneal dialysis solutions and their combinations].
Peritoneal dialysis (PD) treatment has been related to functional and structural changes in peritoneum. The biocompatibility of the PD fluids is one of the most important factors related to this complication. New solutions for PD have been developed in an effort to reduce the bioincompatibility of conventional glucose containing, lactate-buffered solutions, and thereby to improve the clinical outcomes of PD. The use of new manufacturing techniques, buffer presentation, and new osmotic alternatives to glucose (amino acids, icodextrin) have allowed potentially improved peritoneal survival (in terms of structure and function) and improved subjective patient experience. Additional benefits have also included enhanced management of salt and water removal, supported nutritional status and improvement in the systemic metabolic derangements associated with conventional PD treatment, based on glucose-containing lactate-buffered solutions. In vitro and in vivo studies have shown the biocompatibility of these new solutions to be superior to that of standard solutions. This review summarized the characteristics of the next generation of PD fluids currently available and analyzed the potential benefits related to the combination of the different elements.
Bajo
M A
MA
Servicio de Nefrología Hospital, Universitario La Paz, Castellana, 26128046 Madrid. mabajo.hulp@salud.madrid.org
del Peso
G
G
Sánchez-Villanueva
R
R
Castro
M J
MJ
Aroeira
L
L
Selgas
R
R
D000596:Amino Acids / Q000008:administration & dosage; D001639:Bicarbonates / Q000008:administration & dosage; D005936:Glucans / Q000008:administration & dosage; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism; D015312:Hemodialysis Solutions / Q000008:administration & dosage; D006801:Humans; D000077607:Icodextrin; D010530:Peritoneal Dialysis
D000596:Amino Acids; D001639:Bicarbonates; D005936:Glucans; D015312:Hemodialysis Solutions; D000077607:Icodextrin; D005947:Glucose